Tuesday, July 5, 2011

Third Trimester Malaria

On Sunday, Aguak arrived in a lot of pain. Even though she complained of everything BUT malaria, I knew she had it.

She was burning up. She was writhing in pain. She was pregnant.

I admitted her and started her on IV medications because she couldn’t keep anything down. At one point she said she had only been sick a day at most, but her symptoms seemed too severe.

Malaria will cause contractions, and she kept insisting she was in labor. I assured her that once her fever came down and the medicines took effect, her ‘labor’ would stop.

While the quinine slowly dripped into her system, I assessed her baby. This was her first pregnancy, and she was well into her third trimester. Perhaps she WAS in labor.

As I measured her belly and listened for the heartbeat, I was disturbed by the silence. Even though she insisted in a half-dazed malarial rant that the baby was alive since it was moving, I didn’t believe her.

I could feel no movements. I could hear no beating heart.

That was two days ago.

Last night as her medicines had finally worked their magic, she was well enough to understand her child was dead. She took it bravely but it was hard news nonetheless.

Normally, I’d be willing to induce her. But she is still so weak. I’m worried she won’t be able to handle the induction.

After informing the family of the death of the child and potential dangers it poses --the baby decomposing and causing her to get septic or her developing disseminated intravascular coagulation-- I asked them to take her to Wau.

At first I was hopeful. They have the money and even took her home this morning. But then they came back again this evening.

Apparently, despite all their searching they were not able to find a ride to Wau. They seem to be unwilling to go on the bus (I can’t figure out why) and private transportation is too expensive.

Perhaps they will go tomorrow. Please pray that they do.

Pray for Aguak and her child. May mercy, grace, love and peace surround them all during this difficult time. Thanks.